Heart Valve Replacement Option Benefits High-Risk Patients
For patients who could benefit from heart valve replacement but are considered too high-risk for a traditional open heart surgery, MU Health Care offers a less-invasive procedure. It is named transcatheter aortic valve replacement, or TAVR. It is also called transcatheter aortic valve implantation, or TAVI.
In December 2014, MU Health Care began offering this new procedure, which is approved by the Food and Drug Administration (FDA) for people with aortic stenosis who are considered high-risk patients for standard valve replacement surgery. MU’s Heart and Vascular Center is the first in mid-Missouri to offer this procedure.
“With this procedure, we are able to repair the damaged valve using a transcatheter approach, a less invasive method that does not require open-heart surgery,” said Ajit Tharakan, MD, a cardiothoracic surgeon at the MU Heart and Vascular Center. “It is an excellent technology for patients who are extremely high-risk for open-heart surgery. After TAVR, we have seen remarkable improvement. Patients have had a significant resolution of symptoms and improved quality of life.”
To find out more about TAVR or other treatment options available for aortic stenosis, please contact MU's nurse valve coordinator at 573-884-0296.
What is aortic stenosis?
Aortic stenosis is the narrowing of the aortic valve, which prevents the valve from opening completely, to allow blood to flow into the aorta and the rest of the body. It may be caused by: increased age, a birth defect, radiation therapy or rheumatic fever.
What are symptoms of aortic stenosis?
Common symptoms are:
- Shortness of breath
- Heart murmur
- Chest Pain
- Light headedness
Some individuals may experience any of the above symptoms, and the disease goes undetected. If left untreated, sever aortic stenosis can lead to death.
What happens during the TAVR procedure?
During the minimally invasive procedure, a team of interventional cardiologists, imaging specialists and surgeons insert a catheter through an artery in the groin (a transfemoral procedure) or the left side of the base of the chest (a transapical procedure). They then thread the catheter to the heart and position the new heart valve made of biological tissue and implant it over the old valve.
“TAVR allows our team to replace the dysfunctional valve without having to remove the old one,” said Arun Kumar, MD, a cardiologist at the MU Heart and Vascular Center.
After the procedure, patients are monitored in the hospital’s Cardiac Intensive Care Unit. Patients will typically stay in the hospital up to a week before being discharged. After the stay, patients will undergo short-term rehabilitation to regain physical strength.
When does a doctor recommend TAVR?
Although heart-valve replacement offers an improved quality of life for most aortic stenosis patients with severe symptoms, often their age and additional health issues prevent the traditional repair. Although less invasive, TAVR is reserved for patients who are considered high-risk and is not for all heart-valve replacement candidates.
“The open procedure is still the gold standard for most patients,” Kumar said. “However, TAVR is an effective option to improve the quality of life for patients who otherwise have limited choices for repair of their aortic valves.”
What tests are involved?
Patients are thoroughly examined to make sure they are good candidates from the procedure. Screening may include:
All patients who may be candidates for TAVR undergo:
- A walking test
- A frailty assessment
- Quality of life questionnaire to determine the impact of the disease on an individual
Alternatives to TAVR
- Medication: For some patients, medication can improve symptoms of severe aortic stenosis, but it only provides short-term results.
- Balloon Aortic Valvuloplasty: The procedure provides short-term relief of symptoms by inflating a balloon across the narrowed valve and stretching the valve opening. However, the aortic valve will narrow again over time and the symptoms will return.
- Surgical Aortic Valve Replacement: Open-heart surgery is the most common procedure to replace the diseased valve. Surgeons insert an artificial valve made of animal or human tissue or a mechanical valve made from synthetic material.
To learn more about TAVR or other treatment options available for aortic stenosis, please contact MU's nurse valve coordinator at 573-884-0296.